The ACA prescribes basic functions that all exchanges must be able to perform but gives the states some design flexibility. A host of factors are expected to impact the eventual design and functionality of the operating model of a given state exchange. The two main factors are:
- Market Environment – Some states manage markets through regulation, while others employ a free-market approach.
- Exchange Capabilities – Some states will take a de minimis approach, while others will opt to build robust operational capabilities as they bring these exchanges online.
We anticipate that four health insurance exchange operating models will emerge, each with distinct characteristics: Information Aggregator, Retail-oriented Exchange, Guided Exchange, Market Curator (Figure 1).
- Information Aggregator – Takes a laissez-faire approach, where the state facilitates the transaction, and little more.
- Retail-Oriented Exchange – Seeks to develop a competitive marketplace focused on providing a robust shopping experience for the consumer.
- Guided Exchange – Reduces confusion for new consumers by offering a reduced number of more standardized products and a simplified shopping experience.
- Market Curator – Manages competition on a robust platform, where the state curates who can be on the exchange and, to a lesser extent, which products can be offered.
The model that emerges for any given state will factor heavily into a health plan’s decision to participate in the market, as well as influence development of its go-to-market strategy in “entry” states.
That said, after meeting that baseline level of functionality, the fundamental design features of exchanges are left to state discretion. This is the part where a state decides what its market looks like, what the underlying philosophical principles of it are going to be, and what the relationship of the exchange to the private insurers offering plans through it is going to be.
A while back Deloitte laid out different models that will appeal to different states:
The ACA prescribes basic functions that all exchanges must be able to perform but gives the states some design flexibility. A host of factors are expected to impact the eventual design and functionality of the operating model of a given state exchange. The two main factors are:
- Market Environment – Some states manage markets through regulation, while others employ a free-market approach.
- Exchange Capabilities – Some states will take a de minimis approach, while others will opt to build robust operational capabilities as they bring these exchanges online.
We anticipate that four health insurance exchange operating models will emerge, each with distinct characteristics: Information Aggregator, Retail-oriented Exchange, Guided Exchange, Market Curator (Figure 1).
- Information Aggregator – Takes a laissez-faire approach, where the state facilitates the transaction, and little more.
- Retail-Oriented Exchange – Seeks to develop a competitive marketplace focused on providing a robust shopping experience for the consumer.
- Guided Exchange – Reduces confusion for new consumers by offering a reduced number of more standardized products and a simplified shopping experience.
- Market Curator – Manages competition on a robust platform, where the state curates who can be on the exchange and, to a lesser extent, which products can be offered.
The model that emerges for any given state will factor heavily into a health plan’s decision to participate in the market, as well as influence development of its go-to-market strategy in “entry” states.
California's exchange is not going to look like Alabama's, which in turn may not look much like the federal default. The states themselves are responsible for making the basic design decisions that determine what the marketplace looks like in their state. Unless they prefer not to play that role and defer to whatever the federal option ends up looking like.
The exchanges will make it so people can view all the information about differences insurances all in one place, and in a more simpler format. It basically makes for the most efficient form of competition because it allows people to actually know the differences and benefits.
Yes regulators will make it so those in exchanges can't lie or have inaccurate/misleading information and have benefits that are worthless how horrible
The exchanges make it so consumer know the differences between difference insurance policies so they can actually determine which is more valuable to them
No. The mandate only raises your taxes if you do not buy insurance it does not force you to have insurance.
Then why do you know nothing about this stuff you say you have seen before?
Yes, they can. Any other questions?
